Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that surveyed U.S. rheumatologists anticipate using Bristol-Myers Squibb's Orencia and Biogen Idec/Genentech/ Chugai/Zenyaku Kogyo's Rituxan, also marketed as Roche's MabThera, more frequently in first- and second-line biologic therapy through 2010 for the treatment of rheumatoid arthritis.

"Currently, surveyed rheumatologists prescribe Orencia in earlier lines of therapy than Rituxan - 78 percent of them most commonly prescribe Orencia as a third-line biologic, whereas 51 percent of them use Rituxan as a fourth-line biologic," stated Madhuri Borde, Ph.D., analyst at Decision Resources. "Surveyed rheumatologists contend that physician familiarity, concern about the long-term effects of B-cell depletion with Rituxan and preference for Orencia's mechanism of action influences physicians to prescribe Orencia instead of Rituxan."

The new report entitled Treatment Algorithms in Rheumatoid Arthritis also finds that fewer rheumatoid arthritis patients start Amgen/Wyeth/Takeda's Enbrel after another tumor necrosis factor (TNF)-alpha inhibitor versus users of Abbott/Eisai's Humira or Centocor/Schering-Plough/Mitsubishi Tanabe's Remicade. Only 5.3 percent of patients taking Enbrel as a non first-line drug use it after another TNF-alpha inhibitor, compared with 16.0 percent for Humira and 14.4 percent for Remicade.

"All three TNF-alpha inhibitors are vying for first-line biologic use," added Dr. Borde. "However, our current analysis of patient-level claims data shows a much wider disparity than we observed in our 2007 report in the percentage of patients who had received another TNF-alpha inhibitor in the line of treatment preceding Enbrel versus those patients starting either Humira or Remicade as a non first-line drug."

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Members of the media may request an interview with an analyst and are welcome to attend our upcoming webinar entitled Biologics Penetration of Early Lines of Therapy in Psoriasis, Crohn's and Rheumatoid Arthritis: Implications for Existing and Emerging Brands. The webinar will be held on Wednesday, November 19, 2008 at 10 a.m. EST. For more information, please contact Natalia Morales at 781.296.2691 or e-mail at

About Treatment Algorithm Insight Series

Decision Resources combines in-depth primary research with the most extensive claims-based longitudinal patient-level data from PharMetrics® to provide exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease.

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  For more information, contact:    Natalia Morales                 Elizabeth Marshall   Decision Resources              Decision Resources, Inc.   781-296-2691                    781-296-2563 

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SOURCE: Decision Resources

Contact: Natalia Morales of Decision Resources, +1-781-296-2691,; Elizabeth Marshall of Decision Resources, Inc.,

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